Provider Demographics
NPI:1225870744
Name:GOLDFINGER, EVA WRAY (LMSW-CC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:WRAY
Last Name:GOLDFINGER
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 COYLE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-1607
Mailing Address - Country:US
Mailing Address - Phone:617-835-2199
Mailing Address - Fax:
Practice Address - Street 1:25 LONG CREEK DR
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2440
Practice Address - Country:US
Practice Address - Phone:207-535-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC211441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical